Treatment For Very High Triglycerides

What Causes High Triglycerides

High Triglycerides (Part 1) – Medication vs. Lifestyle – Eicosapent Ethyl

Aside from consuming a high-fat and/or high-carb diet, other lifestyle factors can contribute to high triglycerides, specifically excess weight, lack of exercise, drinking too much alcohol and smoking. Dr. Malaney adds that it can also be a side effect of certain medications, such as some birth control pills, beta blockers, antipsychotics medications, and corticosteroids.

What Are The Symptoms

High blood triglycerides usually do not cause any symptoms. Untreated or uncontrolled high blood triglyceride levels may increase your risk of serious complications such as coronary heart disease and stroke.

Very high blood triglycerides can raise the risk of acute pancreatitis, or inflammation of the pancreas that causes severe pain in the abdomen.

What Are Normal Triglyceride Levels

Normal fasting blood triglyceride levels are:

Lower than 150 mg/dL for adults
Lower than 90 mg/dL for children ages 10 to 19

Your doctor may diagnose you with high blood triglycerides if your fasting blood triglyceride levels are consistently 150 milligrams per deciliter or higher.

Talk to your doctor about what your numbers mean for you.

Is Hypertriglyceridemia The Same As High Cholesterol

No, hypertriglyceridemia isnt the same as high cholesterol. These are two different conditions. But they both relate to lipid levels in your blood.

Lipids are fatty substances that perform important jobs in your body. Triglycerides and cholesterol are both types of lipids. And they both travel through your blood in lipoproteins.

Hypertriglyceridemia means you have too many triglycerides in your blood. Hypercholesterolemia means you have too much cholesterol.

Many people who have hypertriglyceridemia also have high total cholesterol. Hypertriglyceridemia is especially dangerous if you also have these cholesterol numbers:

Low HDL cholesterol.
High LDL cholesterol.

Talk with your healthcare provider about what your numbers mean and how to get them back in the healthy range.

Patients With Very High Triglycerides And Treatment With Omega

The prevalence of hypertriglyceridemia has increased several-fold over the past few decades, mostly as a result of the concomitant obesity epidemic.1,2 The categorization of hypertriglyceridemia as endorsed by the 2013 American College of Cardiology /American Heart Association cholesterol guidelines3 and the AHA scientific statement on triglycerides and cardiovascular disease4 is summarized in Table 1. Approximately 40 million adults in the United States have hypertriglyceridemia, and ~4 million have very high triglycerides .5 Indeed, VHTG is more common than numerically analogous increases in total cholesterol levels.6

Table 1: Categorization of Hypertriglyceridemia

Triglyceride Range

Very high

The most alarming untoward effect of VHTG is hypertriglyceridemia-associated pancreatitis.7 Risk of hypertriglyceridemia-associated pancreatitis is more clearly defined at higher TG levels, and is approximately 5 percent with TG > 1,000 mg/dL and 10 to 20 percent with TG > 2,000 m/dL. TG-lowering therapy is recommended in patients with VHTG based on the observation that hypertriglyceridemia-associated pancreatitis tends to be more severe than other etiologies of pancreatitis.8-10 At least three different studies have demonstrated the cost effectiveness of such an approach.11-13

Table 2: Prescription Omega-3 Fatty Acid Formulations

Formulation
Contains EPA and DHA free fatty acids	55% EPA, 20% DHA

References

What Are The Effects Of High Triglycerides

It is unclear if high triglycerides alone are a risk factor for cardiovascular disease . Triglycerides do not directly cause the plaque that can block your heart’s arteries and lead to a heart attack. Yet, cholesterol in triglyceride-rich particles in the blood may add to plaque formation.

Also, many people with high triglycerides have other lipid problems or other risk factors for heart disease. A high triglyceride level is one part of the metabolic syndrome, a cluster of risk factors that increase the risk for heart disease and diabetes.

High triglycerides can affect more than your heart and blood vessels. Very high triglycerides raise the risk for pancreatitis, an inflammation of the pancreas. The pancreas is large gland behind the stomach that makes key hormones like insulin. It helps your body maintain healthy blood glucose levels. Pancreatitis can cause stomach pain and digestive problems. It can damage the pancreas and, over a long time, can lead to diabetes.

How Often Should My Triglycerides Be Tested

If youâre a healthy adult, you should get a lipid profile every 4-6 years. Children should have it done at least once between the ages of 9 and 11, and one more time between 17 and 21. If youâre making changes to your diet or taking medication for high cholesterol or triglycerides, experts advise you to get a lipid profile afterward.

Show Sources

High Triglycerides And Cholesterol: What Is The Difference

Your body needs a certain amount of fat to help promote its cell structure and metabolic function. The term fat is broad and refers to multiple different forms that your body creates or receives from food. Triglycerides are one form that your body produces to store excess energy from your diet. The term cholesterol is broad and used to describe a type of fat floating around in your bloodstream these include HDL and LDL. Cholesterol is produced by the body but it can also be derived from food. It is used for cell and hormone production.

When a person has high levels of LDL, or bad cholesterol, combined with high levels of triglycerides, the chances of plaque formation in their arteries increases, increasing their risk of atherosclerosis .

Not all cholesterol is bad, however, as HDL, or good cholesterol, helps to keep cholesterol from building up inside your arteries and transports it to the liver instead, where it can be expelled from the body.

You need balanced levels of both cholesterol and triglycerides to maintain good cardiovascular health.

What Are Very High Triglycerides

Natural Treatment for High Triglycerides

Just as it sounds, having very high triglycerides means that you have too much of this type of fat in your blood. Your doctor may call this condition severe hypertriglyceridemia.

It is detected through a simple blood test called a lipid panel or lipid profile. This test measures your:

Overall cholesterol
HDL cholesterol

You will likely be asked to get your blood taken after fastingwhen you havent had any food or drink for eight, and sometimes up to 12 hours. This will show your triglyceride level when your body has cleared any cholesterol from meals youve eaten. A triglyceride level done without fasting can also be very revealing because it often shows that your body is not clearing the cholesterol from food.

Your health care provider will likely use your fasting results to guide treatment, but cases can be very different

Like other types of cholesterol, triglycerides are measured in milligrams per deciliter of blood. There are four categories of triglyceride levels according to the American Heart Association. Someone is diagnosed with very high triglycerides when the amount of triglycerides found in the blood is 500 mg/dL or more under 150 mg/dL is considered normal.

Rare Causes Of High Triglycerides

Certain medical conditions and states can cause high triglyceride levels, but they are not as common a trigger as some of the better-known causes. These include:

Familial hypertriglyceridemia: A rare genetic disorder that causes high triglyceride levels that exceed 1,000 mg/dL. As the name suggests, this condition runs in families with members having abnormal levels of high-density lipoprotein , low-density lipoprotein , and triglycerides.

Pregnancy: Triglyceride levels rise in expectant mothers and tend to peak during the third trimester. However, after giving birth, most women experience a return to normal levels.

Liver disease: The liver plays an important role in processing fats. If it becomes compromised in some way, such as in the case of fatty liver disease, overproduction and accumulation of fat in liver cells can occur. This leads to excessive amounts of inflammation and even death if no treatment is implemented. Proper liver function can be disrupted by alcoholism, malnutrition, pregnancy, poisoning, diabetes, hypothyroidism, kidney disease, and lupus.

Medications For High Triglycerides

If diet, exercise, and other lifestyle changes are not sufficiently reducing your triglycerides or your doctor feels your numbers are too high to address the problem with lifestyle interventions alone, they may recommend medication. Some common drugs prescribed to lower triglycerides include:

Statins Statins are appropriate as a cornerstone treatment for moderate to severely high triglyceride levels, according to the AHA/ACC guideline. These prescription drugs help prevent cholesterol from forming in the liver, lower LDL cholesterol and triglycerides, and raise HDL cholesterol, notes the AHA.

Omega-3 fatty acids These essential nutrients are found in fish, flaxseed, and other foods and in fish oil supplements, according to the National Institutes of Health Office of Dietary Supplements . The three main omega-3 fatty acids are alpha-linolenic acid , which is mainly found in plant oils, such as flaxseed and canola, and eicosapentaenoic acid and docosahexaenoic acid , which are found in fish and other seafood.

According to the ODS, many studies have shown that eating fish and seafood rich in omega-3s may help you keep your heart healthy and reduce your risk of heart disease. And boosting your EPA and DHA intake through foods and supplements can help lower your triglycerides.

What Is The Treatment For High Triglycerides

The goal of treatment is to lower your triglycerides. Patients with very severe hypertriglyceridemia should try to lower their triglycerides below 1,000 mg/dL, to reduce their risk for pancreatitis.

Lifestyle changes. The first step for lowering triglycerides is to lose weight if you are overweight, exercise often, and eat a healthy diet low in saturated fat and sugar. Also, limit the amount of refined, processed grains you eat, such as white bread, rice, and pasta. Follow your doctor’s advice about limiting intake of alcohol, which raises triglycerides in somepeople.

Medications. Besides lifestyle changes, you may also need drug treatment. For mildly or moderately high triglycerides, your doctor may prescribe one of these types of drugs:

Fibrates, which greatly lower triglycerides and sometimes raise HDL cholesterol. In the U.S., these prescription drugs include gemfibrozil and fenofibrate.

Niacin, or vitamin B3, at doses of 1,000 to 3,000 mg per day, lowers triglycerides and LDL cholesterol and raises HDL cholesterol. These doses apply to immediate-release niacin, available by prescription or as a supplement. The dose of sustainedrelease niacin, which is only available as a supplement, shouldn’t exceed 2,000 mg per day because of the risk of liver damage.

Ask your doctor if you should see an endocrinologist. This physician specialist can find and treat hormonal causes of high triglycerides.

A Promising New Treatment For High Triglycerides

By Gregory Curfman, MD, Assistant Professor of Medicine, Former Editor-in-Chief, Harvard Health Publishing

When you think about fat circulating in the bloodstream, you might immediately think of cholesterol. But theres another type of fat you shouldnt ignore: triglycerides. As with cholesterol, high triglycerides can also increase the risk of having a heart attack. Existing drugs for lowering triglycerides arent that good at reducing heart attack risk. Thats why a report on a new way to lower triglycerides, New England Journal of Medicine, is generating some excitement among cardiologists.

Don’t Miss: What Is A Good Diet For High Cholesterol

When To Contact A Doctor

While high triglyceride levels may not usually cause symptoms, anyone who is uncertain or concerned about their triglyceride levels should consult a doctor.

Additionally, any adult who has not had a lipid profile test in the last 46 years should speak with a doctor about their cardiovascular risk factors and possible need for a test. Catching elevated levels of health markers, such as triglycerides or cholesterol, at an early stage may help a person make changes earlier to address the underlying issue.

Nutrition / Diet

9 sourcescollapsed

Arnett, D. K., et al. . 2019 ACC/AHA Guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines.

How Can You Lower Triglyceride Levels

If you are diagnosed with high blood triglycerides, your doctor may first recommend that you adopt heart-healthy lifestyle changes. These may include:

Choosing heart-healthy foods and limiting alcohol, added sugars, and foods high in saturated fat
Getting regular physical activity
Aiming for a healthy weight
Getting enough good quality sleep
Managing stress

Simple Tools For A Daily Practice: Non

The ratio of TG to HDL-C represents a summary measure for either elevated TG level, low HDL-C level, or both. The joint occurrence of high TG and low HDL-C is characteristic for the atherogenic dyslipidemia, typically occurring in central obesity, MS, pre-diabetes, and T2DM. Metabolically, the TG/HDL-C ratio is linked to IR, and preponderance of sd LDL particles . In addition, some prospective trials have linked the TG/HDL-C ratio not only with CVD incidence and outcomes, but also with all-cause mortality . Furthermore, a recent analysis of the Very Large Database of Lipids-4 study has revealed that a higher TG/HDL-C ratio was associated with an increasingly atherogenic lipid phenotype, characterized by higher RLP-C, together with higher sd LDL and non-HDL-C levels . Also, based on post hoc analysis of the Scandinavian Simvastatin Survival Study , it has been suggested that patients with elevation of TG/HDL-C ratio tend to have higher benefits from pharmacotherapy than those without elevation of this ratio . Based on this evidence, TG/HDL-C ratio represent another useful tool for medical practice, which can be applied in an evaluation and follow-up of patients with dyslipidemia, T2DM, MS and CVD.

When Should You See A Doctor

High Triglycerides: The Latest Recommendations

Because high triglyceride levels usually do not cause any symptoms, theyre typically spotted when a doctor orders a blood test that includes a lipid panel.

If you do not have high risk factors, including health conditions and some lifestyle factors, a doctor will order a lipid panel every few years to check cholesterol and triglyceride levels.

If your lipid panel results show above normal triglyceride levels, a doctor may suggest lifestyle changes focused on diet and exercise. If diet and exercise do not have the desired effect, they may recommend medication such as statins or fibrates.

What Are The Symptoms Of Hypertriglyceridemia

Most people with hypertriglyceridemia have no symptoms. People with severe hyperglyceridemia may develop xanthomas. These are skin bumps that form when lipids build up under your skin. The xanthomas usually appear around your eyelids. But they may also appear on your knees, elbows or palms of your hands.

Why Are High Triglycerides Bad

Very high levels of triglycerides are associated with liver and pancreas problems.

But studies show conflicting results on the role of high triglycerides and the risk of heart disease. Not all experts agree that triglycerides play a significant role in heart problems.

High triglycerides tend to show up along with other problems, like high blood pressure, diabetes, obesity, high levels of “bad” LDL cholesterol, and low levels of “good” HDL cholesterol. So itâs hard to know for sure which problems are caused by high triglycerides alone.

For instance, some people have a genetic condition that seems to cause high triglyceride levels. But they donât have an increased risk of heart disease. Still, there is some evidence that high triglycerides, on their own, increase the risk of disease. Other studies show that high triglycerides may only play a minor role when other heart disease risks are taken into account.

With ongoing studies, scientists hope to find out whether drugs that lower triglycerides also reduce the risks of heart disease.

Overall, it’s important to remember that improving diet and lifestyle will lower triglycerides and lower the overall risk of heart and blood vessel problems.

Also Check: How To Reduce Cholesterol In Urdu

Know Your Triglyceride Numbers

A blood test called a lipid panel checks both your triglyceride and cholesterol levels. Usually, your doctor will ask that you fast, or not eat or drink anything other than water, for 9-12 hours before the test. Youâll get blood taken from a vein in your arm. Some labs offer non-fasting lipid panels, or they may prick your finger for blood.

Here are the levels, based on a fasting blood test.

Normal: Less than 150 mg/dL
Borderline: 150 to 199 mg/dL
High: 200 to 499 mg/dL
Very High: 500 mg/dL or above

Anyone over age 20 needs to get regular tests to track their cholesterol and triglyceride levels, according to the American Heart Association.

What Questions Should I Ask My Provider

Its important to learn as much as you can about your condition, its causes and available treatments. Consider asking your healthcare provider the following questions:

What do my triglyceride numbers mean?
Do I also have high cholesterol?
Whats the cause of my high triglycerides?
How can I lower my triglycerides?
Whats my risk for cardiovascular disease?
What kinds of exercise are best for me?
Should I meet with a dietitian?

Also Check: Is Garlic Good For High Cholesterol

Parameters To Be Tested

Besides total cholesterol, TG, HDL-cholesterol, and LDL-cholesterol, the lipid profile should include the calculated non-HDL-cholesterol concentration . In addition to elevated TG, patients with hypertriglyceridemia typically have increased total cholesterol, decreased HDL-cholesterol, and normal to low LDL-cholesterol levels. The increase in total cholesterol is explained by the fact that all triglyceride-rich lipoproteins also contain cholesterol, which then raises the total cholesterol level. The parameter non-HDL-cholesterol specifies the amount of cholesterol associated with triglyceride-rich lipoproteins . The advantage of determining non-HDL-cholesterol is that the concentration of all atherogenic lipoproteins can be estimated by measuring one single parameter. The level of non-HDL-cholesterol is more closely correlated with adverse cardiovascular events than that of TG as it also includes LDL-cholesterol. Furthermore, atherogenicity increases with rising TG levels only if more lipoproteins are present, not when existing lipoproteins are loaded with additional TG . Here, the concentration of remnant cholesterol islike the concentration of apolipoprotein Bsuperior to TG concentration as a marker for the amount of abnormal lipoproteins .